Quality-adjusted survival in the first year after the acute respiratory distress syndrome

There is little information on long-term outcome after acute respiratory di stress syndrome (ARDS). We measured quality-adjusted survival in the first year after ARDS in a prospective cohort (n = 200). All patients met traditi onal criteria for ARDS. Patients with sepsis and acute nonpulmonary organ d ysfunction at presentation were excluded. The cohort was healthy before ons et of ARDS as evidenced by high functional status (mean Karnofsky Performan ce Status index: 82.2/100 where greater than or equal to 80 = able to perfo rm normal activities independently) and minimal comorbid illness (mean Char lson-Deyo comorbidity score: 0.32/17 where 0 = absence of chronic illness). We determined quality-adjusted life-years (QALYs) using the Quality of Wel l-being (QWB) scale (0 to 1 scale where 1 = optimal well-being), measured a t 6 and 12 mo. Survival was 69.5 +/- 5.0% at 1 month, fell to 55.7 +/- 3.7% at 6 mo, and did not change at 12 mo, yielding a survival of 59 life-years in the first year per 100 patients with ARDS. QWB was low at 6 and 12 mo ( 0.59 +/- 0.015 and 0.60 +/- 0.015), yielding a quality-adjusted survival of 36 QALYs per 100 patients (sensitivity range: 21 to 46 QALYs). We conclude that ARDS developing in previously healthy patients is associated with poo r quality-adjusted survival. These data are important for cost-effectivenes s analyses and long-term care.